BMC anesthesiology · 2026
Association of preoperative forced vital capacity with prolonged mechanical ventilation after coronary artery bypass grafting: a retrospective cohort Study.
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He Meng, He Liaoming, Zhang Jinwei, Xu Yajing, Zhang Xiwei, Li Xiaoting, Nie Jing, Lai Yongqiang, Ren Changwei, Cui Hao
Аннотация
BACKGROUND: Prolonged mechanical ventilation (PMV) is a serious complication after coronary artery bypass grafting (CABG), yet the association between preoperative pulmonary function and PMV risk remains to be comprehensively evaluated.
METHODS: This study included adult patients who underwent isolated CABG with preoperative pulmonary function testing. Predicted forced vital capacity (FVC), predicted forced expiratory volume in 1 s (FEV₁), and the FEV₁/FVC ratio were assessed for their association with PMV.
RESULTS: Among 1,702 patients, 151 (8.9%) experienced PMV. Patients with PMV were older (65.1 ± 8.5 vs. 62.8 ± 8.8 years, P = 0.003), had higher rates of chronic obstructive pulmonary disease (9.9% vs. 5.4%, P = 0.034) and on-pump CABG (8.6% vs. 1.2%, P < 0.001), lower left ventricular ejection fraction (57.1 ± 10.3% vs. 59.1 ± 8.7%, P = 0.007), lower predicted FVC (82.9 ± 14.0% vs. 88.1 ± 14.9%, P < 0.001), and lower predicted FEV₁ (88.7 ± 15.5% vs. 92.6 ± 16.2%, P = 0.007). They also had higher perioperative mortality (4.0% vs. 0.1%, P < 0.001), longer postoperative hospital stays (10.9 ± 4.2 vs. 8.0 ± 2.6 days, P < 0.001), and greater hospitalization costs (25,309.4 [22,119.4-33,359.3] vs. 18,155.4 [16,665.8-20,001.5] USD, P < 0.001). Restricted cubic spline analysis showed no non-linear relationship between pulmonary function parameters and PMV. After multivariable adjustment, predicted FVC remained independently associated with PMV (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.95-0.99, P = 0.005), whereas predicted FEV₁ did not.
CONCLUSIONS: Nearly one-tenth of patients undergoing CABG required PMV, which was associated with greater healthcare resource utilization and higher perioperative complications. Predicted FVC, but not predicted FEV₁, is an independent predictor of PMV.
METHODS: This study included adult patients who underwent isolated CABG with preoperative pulmonary function testing. Predicted forced vital capacity (FVC), predicted forced expiratory volume in 1 s (FEV₁), and the FEV₁/FVC ratio were assessed for their association with PMV.
RESULTS: Among 1,702 patients, 151 (8.9%) experienced PMV. Patients with PMV were older (65.1 ± 8.5 vs. 62.8 ± 8.8 years, P = 0.003), had higher rates of chronic obstructive pulmonary disease (9.9% vs. 5.4%, P = 0.034) and on-pump CABG (8.6% vs. 1.2%, P < 0.001), lower left ventricular ejection fraction (57.1 ± 10.3% vs. 59.1 ± 8.7%, P = 0.007), lower predicted FVC (82.9 ± 14.0% vs. 88.1 ± 14.9%, P < 0.001), and lower predicted FEV₁ (88.7 ± 15.5% vs. 92.6 ± 16.2%, P = 0.007). They also had higher perioperative mortality (4.0% vs. 0.1%, P < 0.001), longer postoperative hospital stays (10.9 ± 4.2 vs. 8.0 ± 2.6 days, P < 0.001), and greater hospitalization costs (25,309.4 [22,119.4-33,359.3] vs. 18,155.4 [16,665.8-20,001.5] USD, P < 0.001). Restricted cubic spline analysis showed no non-linear relationship between pulmonary function parameters and PMV. After multivariable adjustment, predicted FVC remained independently associated with PMV (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.95-0.99, P = 0.005), whereas predicted FEV₁ did not.
CONCLUSIONS: Nearly one-tenth of patients undergoing CABG required PMV, which was associated with greater healthcare resource utilization and higher perioperative complications. Predicted FVC, but not predicted FEV₁, is an independent predictor of PMV.